Overall Survival Analysis and Characterization of an EGFR Mutated Non-Small Cell Lung Cancer (NSCLC) Population

Aguiar, Filipa; Fernandes, Gabriela; Queiroga, Henrique; Machado, José Carlos; Cirnes, Luı́s; Moura, Conceição Souto; Hespanhol, Venceslau

doi:10.1016/j.arbres.2017.07.012

Cited by 19 publications

(6 citation statements)

References 32 publications

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“…Indeed, previously published studies have also highlighted the NGS superiority over the traditional methods [25,26,27]. Although not an epidemiological study, mutation patterns and frequencies agree with previous data published on our population [28].…”

Section: Discussionsupporting

confidence: 91%

Targeted Gene Next-Generation Sequencing Panel in Patients with Advanced Lung Adenocarcinoma: Paving the Way for Clinical Implementation

Fernandes

Jacob

Martins

et al. 2019

Cancers

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Identification of targetable molecular changes is essential for selecting appropriate treatment in patients with advanced lung adenocarcinoma. Methods: In this study, a Sanger sequencing plus Fluorescence In Situ Hybridization (FISH) sequential approach was compared with a Next-Generation Sequencing (NGS)-based approach for the detection of actionable genomic mutations in an experimental cohort (EC) of 117 patients with advanced lung adenocarcinoma. Its applicability was assessed in small biopsies and cytology specimens previously tested for epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) mutational status, comparing the molecular changes identified and the impact on clinical outcomes. Subsequently, an NGS-based approach was applied and tested in an implementation cohort (IC) in clinical practice. Using Sanger and FISH, patients were classified as EGFR-mutated (n = 22, 18.8%), ALK-mutated (n = 9, 7.7%), and unclassifiable (UC) (n = 86, 73.5%). Retesting the EC with NGS led to the identification of at least one gene variant in 56 (47.9%) patients, totaling 68 variants among all samples. Still, in the EC, combining NGS plus FISH for ALK, patients were classified as 23 (19.7%) EGFR; 20 (17.1%) KRAS; five (4.3%) B-Raf proto-oncogene (BRAF); one (0.9%) Erb-B2 Receptor Tyrosine Kinase 2 (ERBB2); one (0.9%) STK11; one (0.9%) TP53, and nine (7.7%) ALK mutated. Only 57 (48.7%) remained genomically UC, reducing the UC rate by 24.8%. Fourteen (12.0%) patients presented synchronous alterations. Concordance between NGS and Sanger for EGFR status was very high (κ = 0.972; 99.1%). In the IC, a combined DNA and RNA NGS panel was used in 123 patients. Genomic variants were found in 79 (64.2%). In addition, eight (6.3%) EML4-ALK, four (3.1%), KIF5B-RET, four (3.1%) CD74-ROS1, one (0.8%) TPM3-NTRK translocations and three (2.4%) exon 14 skipping MET Proto-Oncogene (MET) mutations were detected, and 36% were treatable alterations. Conclusions: This study supports the use of NGS as the first-line test for genomic profiling of patients with advanced lung adenocarcinoma.

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Section: Discussionsupporting

confidence: 91%

Targeted Gene Next-Generation Sequencing Panel in Patients with Advanced Lung Adenocarcinoma: Paving the Way for Clinical Implementation

Fernandes

Jacob

Martins

et al. 2019

Cancers

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“…Our data show an expected median OS of 12.0 months. This is similar to that reported in a retrospective cohort analysis of patients with NSCLC screened for EGFR mutations between October 2009 and July 2013, in which the median survival of the global population was 12.0 months, with a better OS in mutated than in nonmutated patients (20.0 vs. 11.0 months, respectively; P = 0.007) [27]. However, the populations of both studies are not comparable, since our population was preselected to have completed two lines of active treatment.…”

Section: Discussionsupporting

confidence: 88%

Treatment Patterns and Costs Associated with Stage IV Non-Small Cell Lung Cancer in a Mexican Population: A Chart Review

Alatorre¹,

Campos-Gómez

Mora³

et al. 2019

PharmacoEconomics Open

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Background The available evidence regarding the clinical characteristics, treatment patterns, adverse events (AEs), and costs of treating patients with stage IV non-small cell lung cancer (NSCLC) in Mexico is scarce. Objective Our objective was to describe the clinical characteristics, treatment patterns, and direct costs associated with Mexican patients diagnosed with stage IV NSCLC who had completed two or more lines of systemic antineoplastic treatment. Methods A multicenter retrospective cohort study was designed to collect data from the medical records of patients treated at tertiary-level public hospitals in Mexico (multicenter chart review). We calculated costs from the viewpoint of payers based on data regarding therapy and service utilization. Results A total of 115 patients were included. Median patient age was 61 years (interquartile range [IQR] 52.4-68.5), and 51.3% were female. The most common NSCLC type was non-squamous (92.2%), and the typical histology was adenocarcinoma (88.7%). All patients received first-and second-line therapy: 54.78% completed a third-line, 27.82% a fourth-line, 7.82% a fifth-line, 2.6% a sixth-line, and 1.7% a seventh-line active therapy. Carboplatin was the most frequently used therapy (28.6%) followed by docetaxel (23.3%), nivolumab (16.7%), and irinotecan (13.3%). AEs occurred in 53% of the patients and none was fatal. In total, 59 patients (51.3%) required hospitalization during the observation period. The median cost per patient was $US7039.40, with a minimum of $US628.30 and a maximum of $US3,557,364.20. Median overall survival of the cohort was 12 months (95% confidence interval 9.8-14.1). Conclusions In Mexico, NSCLC is usually diagnosed at stage IV. This study shows considerable variation in chemotherapy regimens, leading to a wide range in treatment cost. The understanding of NSCLC treatment patterns in Mexico will help to identify and address unmet needs.

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“…The median overall survival within the EGFR -mutated subgroup surpassed that of the wild-type EGFR cohort. Similar findings were reported in a distinct study encompassing a Caucasian population of 285 non-small-cell lung cancer patients, wherein patients with EGFR mutations demonstrated a markedly prolonged overall survival compared to their wild-type EGFR counterparts [ 37 ]. Furthermore, within an Asian patient cohort of 424 cases, Zheng et al reported that patients with EGFR mutations experienced a significantly longer survival duration to those with wild-type EGFR [ 38 ].…”

Section: Discussionsupporting

confidence: 85%

Clinicopathological and prognostic implications of EGFR mutations subtypes in Moroccan non-small cell lung cancer patients: A first report

Boukansa,

Mouhrach,

El Agy

et al. 2024

PLoS ONE

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Background Non-small cell lung cancer (NSCLC) remains a significant global health concern, with EGFR mutations playing a pivotal role in guiding treatment decisions. This prospective study investigated the prevalence and clinical implications of EGFR mutations in Moroccan NSCLC patients. Methods A cohort of 302 NSCLC patients was analyzed for EGFR mutations using multiple techniques. Demographic, clinical, and pathological characteristics were assessed, and overall survival (OS) outcomes were compared among different EGFR mutation subtypes. Results EGFR mutations were present in 23.5% of patients, with common mutations (81.69%) dominating. Common mutations showed strong associations with female gender and non-smoking status, while rare mutations were associated with a positive smoking history. Patients with EGFR mutations receiving tyrosine kinase inhibitors (TKIs) had significantly improved OS compared to wild-type EGFR patients. Notably, patients with common EGFR mutations had the highest OS, while those with rare mutations had a shorter survival period, albeit not statistically significant. Conclusion This study highlights the relevance of EGFR mutation status in NSCLC patients, particularly in therapeutic decision-making. The association between smoking history and rare mutations suggests the need for tailored approaches. The survival advantage for patients with common EGFR mutations underscores the significance of personalized treatment strategies.

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Overall Survival Analysis and Characterization of an EGFR Mutated Non-Small Cell Lung Cancer (NSCLC) Population

Cited by 19 publications

References 32 publications

Targeted Gene Next-Generation Sequencing Panel in Patients with Advanced Lung Adenocarcinoma: Paving the Way for Clinical Implementation

Targeted Gene Next-Generation Sequencing Panel in Patients with Advanced Lung Adenocarcinoma: Paving the Way for Clinical Implementation

Treatment Patterns and Costs Associated with Stage IV Non-Small Cell Lung Cancer in a Mexican Population: A Chart Review

Clinicopathological and prognostic implications of EGFR mutations subtypes in Moroccan non-small cell lung cancer patients: A first report

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